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Hirchak KA, Hernandez-Vallant A, Herron J, Cloud V, Tonigan JS, McCrady B, Venner K. Aligning three substance use disorder interventions among a tribe in the Southwest United States: Pilot feasibility for cultural re-centering, dissemination, and implementation. J Ethn Subst Abuse 2020; 21:1-17. [PMID: 33135985 PMCID: PMC8095342 DOI: 10.1080/15332640.2020.1836701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this article we describe cultural re-centering, dissemination, and implementation activities in partnership between an American Indian reservation community and a university in the Southwest United States. We offer examples of cultural adaptation and implementation of evidence-based treatments (e.g., Motivational Interviewing, Community Reinforcement Approach and the Community Reinforcement and Family Training) using the Interactive Systems Framework. Facilitators and barriers are described within each study including recruitment strategies, training, and sustainability of counselors in the community. Through this Tribal-university partnership, we offer insight on the cultural adaptation and implementation process that will be translatable and clinically meaningful to other rural and reservation communities.
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Affiliation(s)
- Katherine A. Hirchak
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
| | - Alexandra Hernandez-Vallant
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
| | - Jalene Herron
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
| | - Violette Cloud
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
| | - J. Scott Tonigan
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Barbara McCrady
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Kamilla Venner
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
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Abstract
BACKGROUND Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. OBJECTIVES To assess the effectiveness of mass media interventions in reducing smoking among adults. SEARCH METHODS The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in November 2016. SELECTION CRITERIA Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series.Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included.Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes.The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, or odds of being a smoker. DATA COLLECTION AND ANALYSIS Two authors independently assessed all studies for inclusion criteria and for study quality (MB, LS, RTM). One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of the included studies and are presented narratively and in table form. MAIN RESULTS Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among seven campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the eight studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. AUTHORS' CONCLUSIONS There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign. Another (California) showed positive results during the period of adequate funding and implementation and in final evaluation since the beginning of the programme. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow-up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.
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Affiliation(s)
- Malgorzata M Bala
- Jagiellonian University Medical CollegeChair of Epidemiology and Preventive Medicine; Department of Hygiene and Dietetics; Systematic Reviews Unit ‐ Polish Cochrane BranchKopernika 7KrakowPoland31‐034
| | | | - Roman Topor‐Madry
- Institute of Public Health, Jagiellonian University Medical CollegeDepartment of Epidemiology and Population StudiesGrzegórzecka 20KrakowPoland31‐531
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Mosdøl A, Lidal IB, Straumann GH, Vist GE. Targeted mass media interventions promoting healthy behaviours to reduce risk of non-communicable diseases in adult, ethnic minorities. Cochrane Database Syst Rev 2017; 2:CD011683. [PMID: 28211056 PMCID: PMC6464363 DOI: 10.1002/14651858.cd011683.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Physical activity, a balanced diet, avoidance of tobacco exposure, and limited alcohol consumption may reduce morbidity and mortality from non-communicable diseases (NCDs). Mass media interventions are commonly used to encourage healthier behaviours in population groups. It is unclear whether targeted mass media interventions for ethnic minority groups are more or less effective in changing behaviours than those developed for the general population. OBJECTIVES To determine the effects of mass media interventions targeting adult ethnic minorities with messages about physical activity, dietary patterns, tobacco use or alcohol consumption to reduce the risk of NCDs. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, ERIC, SweMed+, and ISI Web of Science until August 2016. We also searched for grey literature in OpenGrey, Grey Literature Report, Eldis, and two relevant websites until October 2016. The searches were not restricted by language. SELECTION CRITERIA We searched for individual and cluster-randomised controlled trials, controlled before-and-after studies (CBA) and interrupted time series studies (ITS). Relevant interventions promoted healthier behaviours related to physical activity, dietary patterns, tobacco use or alcohol consumption; were disseminated via mass media channels; and targeted ethnic minority groups. The population of interest comprised adults (≥ 18 years) from ethnic minority groups in the focal countries. Primary outcomes included indicators of behavioural change, self-reported behavioural change and knowledge and attitudes towards change. Secondary outcomes were the use of health promotion services and costs related to the project. DATA COLLECTION AND ANALYSIS Two authors independently reviewed the references to identify studies for inclusion. We extracted data and assessed the risk of bias in all included studies. We did not pool the results due to heterogeneity in comparisons made, outcomes, and study designs. We describe the results narratively and present them in 'Summary of findings' tables. We judged the quality of the evidence using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. MAIN RESULTS Six studies met the inclusion criteria, including three RCTs, two cluster-RCTs and one ITS. All were conducted in the USA and comprised targeted mass media interventions for people of African descent (four studies), Spanish-language dominant Latino immigrants (one study), and Chinese immigrants (one study). The two latter studies offered the intervention in the participants' first language (Spanish, Cantonese, or Mandarin). Three interventions targeted towards women only, one pregnant women specifically. We judged all studies as being at unclear risk of bias in at least one domain and three studies as being at high risk of bias in at least one domain.We categorised the findings into three comparisons. The first comparison examined mass media interventions targeted at ethnic minorities versus an equivalent mass media intervention intended for the general population. The one study in this category (255 participants of African decent) found little or no difference in effect on self-reported behavioural change for smoking and only small differences in attitudes to change between participants who were given a culturally specific smoking cessation booklet versus a booklet intended for the general population. We are uncertain about the effect estimates, as assessed by the GRADE methodology (very low quality evidence of effect). No study provided data for indicators of behavioural change or adverse effects.The second comparison assessed targeted mass media interventions versus no intervention. One study (154 participants of African decent) reported effects for our primary outcomes. Participants in the intervention group had access to 12 one-hour live programmes on cable TV and received print material over three months regarding nutrition and physical activity to improve health and weight control. Change in body mass index (BMI) was comparable between groups 12 months after the baseline (low quality evidence). Scores on a food habits (fat behaviours) and total leisure activity scores changed favourably for the intervention group (very low quality evidence). Two other studies exposed entire populations in geographical areas to radio advertisements targeted towards African American communities. Authors presented effects on two of our secondary outcomes, use of health promotion services and project costs. The campaign message was to call smoking quit lines. The outcome was the number of calls received. After one year, one study reported 18 calls per estimated 10,000 targeted smokers from the intervention communities (estimated target population 310,500 persons), compared to 0.2 calls per estimated 10,000 targeted smokers from the control communities (estimated target population 331,400 persons) (moderate quality evidence). The ITS study also reported an increase in the number of calls from the target population during campaigns (low quality evidence). The proportion of African American callers increased in both studies (low to very low quality evidence). No study provided data on knowledge and attitudes for change and adverse effects. Information on costs were sparse.The third comparison assessed targeted mass media interventions versus a mass media intervention plus personalised content. Findings are based on three studies (1361 participants). Participants in these comparison groups received personal feedback. Two of the studies recorded weight changes over time. Neither found significant differences between the groups (low quality evidence). Evidence on behavioural changes, and knowledge and attitudes typically found some effects in favour of receiving personalised content or no significant differences between groups (very low quality evidence). No study provided data on adverse effects. Information on costs were sparse. AUTHORS' CONCLUSIONS The available evidence is inadequate for understanding whether mass media interventions targeted toward ethnic minority populations are more effective in changing health behaviours than mass media interventions intended for the population at large. When compared to no intervention, a targeted mass media intervention may increase the number of calls to smoking quit line, but the effect on health behaviours is unclear. These studies could not distinguish the impact of different components, for instance the effect of hearing a message regarding behavioural change, the cultural adaptation to the ethnic minority group, or increase reach to the target group through more appropriate mass media channels. New studies should explore targeted interventions for ethnic minorities with a first language other than the dominant language in their resident country, as well as directly compare targeted versus general population mass media interventions.
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Affiliation(s)
- Annhild Mosdøl
- Norwegian Institute of Public HealthKnowledge Centre for the Health ServicesPO BOX 4404 NydalenOsloNorway
| | - Ingeborg B Lidal
- Norwegian Institute of Public HealthKnowledge Centre for the Health ServicesPO BOX 4404 NydalenOsloNorway
- Sunnaas Rehabilitation HospitalTRS National Resource Centre for Rare DisordersNesoddtangenNorway1450
| | - Gyri H Straumann
- Norwegian Institute of Public HealthKnowledge Centre for the Health ServicesPO BOX 4404 NydalenOsloNorway
| | - Gunn E Vist
- Norwegian Knowledge Centre for the Health ServicesPrevention, Health Promotion and Organisation UnitPO Box 7004St Olavs PlassOsloNorway0130
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Ma GX, Fleisher L, Gonzalez E, Edwards RL. Improving Cancer Awareness among Asian Americans Using Targeted and Culturally Appropriate Media: A Case Study. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2016. [DOI: 10.1177/1084822304268156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Reaching Asian Americans with cancer awareness messages is critical to improving cancer detection and reducing risk. Two separate targeted media campaigns, sponsored by the Asian Tobacco Education, Cancer Awareness, and Research (ATECAR), were implemented to increase cancer awareness among Chinese, Koreans, Vietnamese, and Cambodians residing in Philadelphia and the surrounding counties. These campaigns, based on Rogers’s diffusion and innovation theoretical model, were culturally sensitive, multilingual, and implemented over an extended time frame using print articles and a radio series under the respective general headings ATECAR Link and Voice of ATECAR. The series covered a range of topics that included tobacco smoking and health, cervical and breast cancer, clinical trials, and cancer information. Despite a reputation for noninvolvement in mainstream cancerrelated media issues, results of the campaigns reflected an exceptional response from the targeted communities. The results suggest that wellplanned, community-based media campaigns can have positive impacts on cancer awareness in Asian communities.
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Affiliation(s)
- Grace X. Ma
- Center for Asian Health, Department of Public Health, Temple University
| | | | | | - Rosita L. Edwards
- Center for Asian Health, Department of Public Health, Temple University
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Waters EA, McQueen A, Caburnay CA, Boyum S, Sanders Thompson VL, Kaphingst KA, Kreuter MW. Perceptions of the US National Tobacco Quitline Among Adolescents and Adults: A Qualitative Study, 2012-2013. Prev Chronic Dis 2015; 12:E131. [PMID: 26292062 PMCID: PMC4556101 DOI: 10.5888/pcd12.150139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Introduction Tobacco quitlines are critical components of comprehensive tobacco control programs. However, use of the US National Tobacco Quitline (1-800-QUIT-NOW) is low. Promoting quitlines on cigarette warning labels may increase call volume and smoking cessation rates but only if smokers are aware of, and receptive to, quitline services. Methods We conducted qualitative interviews with a diverse subset (n = 159) of adolescent (14–17 y) and adult (≥18 y) participants of a larger quantitative survey about graphic cigarette warning labels (N = 1,590). A convenience sample was recruited from schools and community organizations in 6 states. Interviews lasted 30 to 45 minutes and included questions to assess basic knowledge and perceptions of the quitline number printed on the warning labels. Data were analyzed using content analysis. Results Four themes were identified: available services, caller characteristics, quitline service provider characteristics, and logistics. Participants were generally knowledgeable about quitline services, including the provision of telephone-based counseling. However, some adolescents believed that quitlines provide referrals to “rehab.” Quitline callers are perceived as highly motivated — even desperate — to quit. Few smokers were interested in calling the quitline, but some indicated that they might call if they were unable to quit independently. It was generally recognized that quitline services are or should be free, confidential, and operated by governmental or nonprofit agencies, possibly using tobacco settlement funds. Conclusion Future marketing efforts should raise awareness of the nature and benefits of quitline services to increase use of these services and, consequently, reduce tobacco use, improve public health, and reduce tobacco-related health disparities.
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Affiliation(s)
- Erika A Waters
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8100, Saint Louis, MO 63110.
| | - Amy McQueen
- Washington University School of Medicine, St. Louis, Missouri
| | | | - Sonia Boyum
- Washington University in St. Louis, St. Louis, Missouri
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Duke JC, Mann N, Davis KC, MacMonegle A, Allen J, Porter L. The impact of a state-sponsored mass media campaign on use of telephone quitline and web-based cessation services. Prev Chronic Dis 2014; 11:E225. [PMID: 25539129 PMCID: PMC4279867 DOI: 10.5888/pcd11.140354] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Most US smokers do not use evidence-based interventions as part of their quit attempts. Quitlines and Web-based treatments may contribute to reductions in population-level tobacco use if successfully promoted. Currently, few states implement sustained media campaigns to promote services and increase adult smoking cessation. This study examines the effects of Florida's tobacco cessation media campaign and a nationally funded media campaign on telephone quitline and Web-based registrations for cessation services from November 2010 through September 2013. METHODS We conducted multivariable analyses of weekly media-market-level target rating points (TRPs) and weekly registrations for cessation services through the Florida Quitline (1-877-U-CAN-NOW) or its Web-based cessation service, Web Coach (www.quitnow.net/florida). RESULTS During 35 months, 141,221 tobacco users registered for cessation services through the Florida Quitline, and 53,513 registered through Web Coach. An increase in 100 weekly TRPs was associated with an increase of 7 weekly Florida Quitline registrants (β = 6.8, P < .001) and 2 Web Coach registrants (β = 1.7, P = .003) in an average media market. An increase in TRPs affected registrants from multiple demographic subgroups similarly. When state and national media campaigns aired simultaneously, approximately one-fifth of Florida's Quitline registrants came from the nationally advertised portal (1-800-QUIT-NOW). CONCLUSION Sustained, state-sponsored media can increase the number of registrants to telephone quitlines and Web-based cessation services. Federally funded media campaigns can further increase the reach of state-sponsored cessation services.
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Affiliation(s)
- Jennifer C Duke
- RTI International, 3040 East Cornwallis Rd, Research Triangle Park, NC 27709. E-mail:
| | - Nathan Mann
- RTI International, Research Triangle Park, North Carolina
| | - Kevin C Davis
- RTI International, Research Triangle Park, North Carolina
| | | | - Jane Allen
- RTI International, Research Triangle Park, North Carolina
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Liu JJ, Wabnitz C, Davidson E, Bhopal RS, White M, Johnson MRD, Netto G, Sheikh A. Smoking cessation interventions for ethnic minority groups--a systematic review of adapted interventions. Prev Med 2013; 57:765-75. [PMID: 24076130 DOI: 10.1016/j.ypmed.2013.09.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 08/22/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Existing smoking cessation interventions tend to be under utilized by ethnic minority groups. We sought to identify smoking cessation interventions that have been adapted to meet the needs of African-, Chinese- and South Asian-origin populations, to increase understanding of the approaches used to promote behavior change, to assess their acceptability to the target populations, and to evaluate their effectiveness. METHODS Two reviewers independently searched for, identified, critically appraised and extracted data from studies identified from 11 databases (January 1950-April 2013). Study quality was assessed using validated instruments (EPHPP and STROBE). Adaptations were independently coded using an established typology, and findings descriptively summarized and thematically synthesized. RESULTS 23 studies described interventions adapted for African-Americans, and five for Chinese-origin populations. No intervention adapted for South-Asian populations was identified. Six studies directly compared a culturally adapted versus a non-adapted intervention. Adapted interventions were more acceptable to ethnic minority groups, but this did not translate into improvements in smoking cessation outcomes. CONCLUSIONS Given the evidence of greater acceptability of adapted interventions, it may be ethically preferable to use these. There is, however, no clear evidence of the effectiveness of adapted interventions in promoting smoking cessation in ethnic minority groups.
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Affiliation(s)
- Jing Jing Liu
- Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
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Stanton AL, Morra ME, Diefenbach MA, Miller SM, Slevin Perocchia R, Raich PC, Fleisher L, Wen KY, Tran ZV, Mohamed NE, George R, Bright MA, Marcus AC. Responding to a significant recruitment challenge within three nationwide psychoeducational trials for cancer patients. J Cancer Surviv 2013; 7:392-403. [PMID: 23595235 PMCID: PMC3737366 DOI: 10.1007/s11764-013-0282-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 03/11/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE When faced with a significant recruitment challenge for three nationwide psychoeducational trials targeting prostate and breast cancer patients, the Cancer Information Service Research Consortium initiated outreach efforts to increase accrual. Recruitment is reported by major outreach strategy to inform the use of similar campaigns, either as primary recruitment efforts or to supplement "in-reach" recruitment within oncology settings. METHODS During a 33-month period, recruitment was tracked from the National Cancer Institute's Cancer Information Service (CIS), the American Cancer Society (ACS), Dr. Susan Love Research Foundation's Love/Avon Army of Women (AOW), Internet advertising, press releases, radio/television interviews, recruitment materials in community venues, and outreach to churches and cancer support organizations. RESULTS Across projects, the majority (89 %) of recruited participants (N = 2,134) was obtained from the CIS (n = 901, 19 months of recruitment), AOW (n = 869, 18 months), and ACS (n = 123, 12 months). Other efforts showed minimal gain in recruitment. CONCLUSIONS Cancer information programs (e.g., CIS and ACS) and registries of individuals willing to participate in cancer-related research (e.g., AOW) can represent exceptional resources for outreach recruitment of cancer patients, especially when the eligibility criteria are highly restrictive. However, these resources do not yield samples representative of the larger population of adults diagnosed with cancer, and conclusions from such trials must be tempered accordingly. IMPLICATIONS FOR CANCER SURVIVORS Inadequate recruitment to randomized controlled trials limits the creation of useful interventions for cancer survivors. By enrolling in cancer registries and taking part in research, cancer survivors can contribute to the development of effective resources for the survivor population.
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Affiliation(s)
- Annette L Stanton
- Departments of Psychology and Psychiatry/Biobehavioral Sciences, Jonsson Comprehensive Cancer Center, University of California-Los Angeles, Los Angeles, CA 90095-1563, USA.
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Bala MM, Strzeszynski L, Topor-Madry R, Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database Syst Rev 2013:CD004704. [PMID: 23744348 DOI: 10.1002/14651858.cd004704.pub3] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. OBJECTIVES To assess the effectiveness of mass media interventions in reducing smoking among adults. SEARCH METHODS The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in February 2013. SELECTION CRITERIA Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series. Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included. Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes. The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, odds of being a smoker. DATA COLLECTION AND ANALYSIS Two authors independently assessed all studies for inclusion criteria and for study quality. One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of the included studies and are presented narratively and in table form. MAIN RESULTS Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among nine campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the seven studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. AUTHORS' CONCLUSIONS There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign. Another (California) showed positive results during the period of adequate funding and implementation and in final evaluation since the beginning of the programme. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow-up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.
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Affiliation(s)
- Malgorzata M Bala
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.
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Peters RJ, Kelder SH, Johnson RJ, Prokhorov AV, Meshack A, Jefferson T, Essien EJ. Cigarette smoking topography among alternative school youth: why African American youth smoke less but are at higher long-term risk. J Psychoactive Drugs 2012; 44:252-8. [PMID: 23061325 DOI: 10.1080/02791072.2012.703514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A paradox exists in health disparities research where African-American cigarette smokers consume fewer cigarettes per day, yet experience higher rates of tobacco-related disease compared to White American smokers. In this study we conducted focus group interviews among alternative high school youth (N = 78; age 18-19 years old) in an urban area in Southwest Texas to investigate if African-American youth smoke cigarettes differently than their White-American and Hispanic-American counterparts. The majority of African-American participants reported inhaling deeper and smoking their cigarettes "to the filter" because of their concern over wasting any part of an expensive cigarette. White and Hispanic respondents most often put out their cigarettes closer to the middle, and did not express concern about wasting cigarettes. The implication from this qualitative study is that because African Americans smoke differently they are exposed to a higher level of harmful particulate per cigarette. Further research on smoking topography is warranted.
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Affiliation(s)
- Ronald J Peters
- University of Texas-Houston, School of Public Health, 7000 Fannin, Suite 2618, Houston, TX 77030, USA.
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Guillaumier A, Bonevski B, Paul C. Anti-tobacco mass media and socially disadvantaged groups: a systematic and methodological review. Drug Alcohol Rev 2012; 31:698-708. [PMID: 22571783 DOI: 10.1111/j.1465-3362.2012.00466.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
ISSUES Only a limited amount of research has been conducted to explore whether there are socioeconomic status differences in responses to mass media. However, the methodological quality of this evidence has not been assessed, limiting confidence in conclusions that can be drawn regarding study outcomes. A systematic review of the effectiveness of anti-tobacco mass media campaigns with socially disadvantaged groups was conducted, and the methodological quality of included studies was assessed. APPROACH Medline, The Cochrane Library, PsycInfo, Embase and Web of Science were searched using MeSH and keywords for quantitative studies conducted in Western countries prior to March 2012. A methodological quality assessment and narrative analysis of included studies was undertaken. KEY FINDINGS Seventeen relevant studies (reported in 18 papers) were identified; however, weak study designs and selection bias were common characteristics, limiting strong conclusions about effectiveness. Using predominantly non-cessation related outcome measures reviewed papers indicated mixed results for mass media tobacco control campaign effectiveness among various social groups. Most studies assessed mass media impact on low socioeconomic status groups rather than highly socially disadvantaged groups. IMPLICATIONS Methodological rigour of evaluations in this field must be improved to aid understanding regarding the effectiveness of mass media campaigns in driving cessation among disadvantaged groups. CONCLUSION The results of this review indicate a gap in methodologically rigorous research into the effectiveness of mass media campaigns among socially disadvantaged groups, particularly the highly disadvantaged.
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Affiliation(s)
- Ashleigh Guillaumier
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
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Harrison TR, Morgan SE, King AJ, Williams EA. Saving lives branch by branch: the effectiveness of driver licensing bureau campaigns to promote organ donor registry sign-ups to African Americans in Michigan. JOURNAL OF HEALTH COMMUNICATION 2011; 16:805-819. [PMID: 21491308 DOI: 10.1080/10810730.2011.552001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
African Americans are disproportionately represented on the national waiting list for organ transplantation. Promoting organ donor registries is one way to improve the possibility that those on the waiting list can receive a life saving transplant. Driver licensing bureaus have been suggested as an efficient site for campaigns aimed at increasing state-based registry sign-ups. Previous research has suggested these campaigns work well for Caucasian populations, but there is less evidence supporting this approach in more diverse populations. To determine whether more diverse populations demonstrate similar sign-up rates when receiving a driver licensing bureau campaign, the present study used a previously successful strategy as the basis for designing and disseminating materials that would appeal to African Americans and Caucasians in two diverse counties in the state of Michigan (Wayne and Oakland Counties). Communication design and media priming served as the theoretical foundations of a three-prong campaign that used mass media, point-of-decision, and interpersonal components. Results from countywide and zip code data indicate that the campaign greatly increased sign-ups among African American residents (700% increase above baseline). Although more Caucasians still signed up than did African Americans, the inclusion of an interpersonal component resulted in similar numbers of registry sign-ups during 2 intervention months. The study provides evidence supporting the use of driver licensing bureau campaigns to promote organ donation registries to diverse audiences.
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Affiliation(s)
- Tyler R Harrison
- Department of Communication, Purdue University, West Lafayette, Indiana 47907, USA.
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Begh RA, Aveyard P, Upton P, Bhopal RS, White M, Amos A, Prescott RJ, Bedi R, Barton P, Fletcher M, Gill P, Zaidi Q, Sheikh A. Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: pilot cluster randomised controlled trial of trained community outreach workers. Trials 2011; 12:197. [PMID: 21854596 PMCID: PMC3177779 DOI: 10.1186/1745-6215-12-197] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 08/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services. METHODS A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed. RESULTS We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500. CONCLUSIONS The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery. TRIAL REGISTRATION Current Controlled Trials ISRCTN82127540.
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Affiliation(s)
- Rachna A Begh
- UK Centre for Tobacco Control Studies, Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Paul Aveyard
- UK Centre for Tobacco Control Studies, Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Penney Upton
- Psychological Sciences, Institute of Health and Society, University of Worcester, Worcester, WR2 6AJ, UK
| | - Raj S Bhopal
- Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Martin White
- Fuse, UKCRC Centre for Translational Research in Public Health, Institute of Health & Society, Newcastle University, NE2 4HH, UK
| | - Amanda Amos
- UK Centre for Tobacco Control Studies, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Robin J Prescott
- Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Raman Bedi
- International Centre for Child Oral Health, King's College London, London, WC2B 5RL, UK
| | - Pelham Barton
- Health Economics, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Paramjit Gill
- UK Centre for Tobacco Control Studies, Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Qaim Zaidi
- British Heart Foundation, London, W1H 6DH, UK
| | - Aziz Sheikh
- Allergy & Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, UK
- CAPHRI, University of Maastricht, The Netherlands
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Zhu SH, Gardiner P, Cummins S, Anderson C, Wong S, Cowling D, Gamst A. Quitline Utilization Rates of African-American and White Smokers: The California Experience. Am J Health Promot 2011; 25:S51-8. [DOI: 10.4278/ajhp.100611-quan-185] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To compare the utilization rate of a statewide tobacco quitline by African-American smokers to that of white smokers. Design, Setting, and Subjects. Observational study of 18 years of state quitline operation in California. Subjects were 61,096 African-American and 279,042 white smokers who called the quitline from August 1992 to December 2009. Data from six California Tobacco Surveys, 1993, 1996, 1999, 2002, 2005, and 2008 were also used. Measure. Callers' answers to the question how they heard about the quitline were grouped into four categories: media, health care providers, friends/family, and others. Analysis. The averaged annual quitline call volume for each ethnic group was divided by the total number of smokers in that group, based on California Tobacco Surveys, to produce the annual quitline utilization rate. Results. In five out of six periods of comparison, African-American smokers had a higher annual utilization rate than white smokers. The odds ratios [ORs] ranged from 1.44 to 2.40 (all p < .05). In the 1996 comparison, the OR was .90 (p < .05). The difference in utilization rates that is attributed to media, accounts for most of the difference in total utilization rates between the two ethnic groups. Conclusions. Within the context of California's comprehensive tobacco control program, which includes a strong media campaign, African-American smokers were significantly more likely to call the state quitline than white smokers were. Promoting the quitline as part of antismoking media campaigns can help reduce disparity in cessation service utilization. (Am J Health Promot 2011;25[5 Supplement]:S51–S58.)
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Affiliation(s)
- Shu-Hong Zhu
- Shu-Hong Zhu, PhD, is a Professor, and Anthony Gamst, PhD, is an Associate Professor, Department of Family and Preventive Medicine; and Sharon Cummins, PhD, Christopher Anderson, BA, and Shiushing Wong, PhD, are with Moores Cancer Center, University of California, San Diego, La Jolla, California. Phillip Gardiner, PhD, is a Social and Behavioral Sciences and Nicotine Dependence Research Administrator, Tobacco Related Disease Research Program (TRDRP), Office of the President, University of California,
| | - Phillip Gardiner
- Shu-Hong Zhu, PhD, is a Professor, and Anthony Gamst, PhD, is an Associate Professor, Department of Family and Preventive Medicine; and Sharon Cummins, PhD, Christopher Anderson, BA, and Shiushing Wong, PhD, are with Moores Cancer Center, University of California, San Diego, La Jolla, California. Phillip Gardiner, PhD, is a Social and Behavioral Sciences and Nicotine Dependence Research Administrator, Tobacco Related Disease Research Program (TRDRP), Office of the President, University of California,
| | - Sharon Cummins
- Shu-Hong Zhu, PhD, is a Professor, and Anthony Gamst, PhD, is an Associate Professor, Department of Family and Preventive Medicine; and Sharon Cummins, PhD, Christopher Anderson, BA, and Shiushing Wong, PhD, are with Moores Cancer Center, University of California, San Diego, La Jolla, California. Phillip Gardiner, PhD, is a Social and Behavioral Sciences and Nicotine Dependence Research Administrator, Tobacco Related Disease Research Program (TRDRP), Office of the President, University of California,
| | - Christopher Anderson
- Shu-Hong Zhu, PhD, is a Professor, and Anthony Gamst, PhD, is an Associate Professor, Department of Family and Preventive Medicine; and Sharon Cummins, PhD, Christopher Anderson, BA, and Shiushing Wong, PhD, are with Moores Cancer Center, University of California, San Diego, La Jolla, California. Phillip Gardiner, PhD, is a Social and Behavioral Sciences and Nicotine Dependence Research Administrator, Tobacco Related Disease Research Program (TRDRP), Office of the President, University of California,
| | - Shiushing Wong
- Shu-Hong Zhu, PhD, is a Professor, and Anthony Gamst, PhD, is an Associate Professor, Department of Family and Preventive Medicine; and Sharon Cummins, PhD, Christopher Anderson, BA, and Shiushing Wong, PhD, are with Moores Cancer Center, University of California, San Diego, La Jolla, California. Phillip Gardiner, PhD, is a Social and Behavioral Sciences and Nicotine Dependence Research Administrator, Tobacco Related Disease Research Program (TRDRP), Office of the President, University of California,
| | - David Cowling
- Shu-Hong Zhu, PhD, is a Professor, and Anthony Gamst, PhD, is an Associate Professor, Department of Family and Preventive Medicine; and Sharon Cummins, PhD, Christopher Anderson, BA, and Shiushing Wong, PhD, are with Moores Cancer Center, University of California, San Diego, La Jolla, California. Phillip Gardiner, PhD, is a Social and Behavioral Sciences and Nicotine Dependence Research Administrator, Tobacco Related Disease Research Program (TRDRP), Office of the President, University of California,
| | - Anthony Gamst
- Shu-Hong Zhu, PhD, is a Professor, and Anthony Gamst, PhD, is an Associate Professor, Department of Family and Preventive Medicine; and Sharon Cummins, PhD, Christopher Anderson, BA, and Shiushing Wong, PhD, are with Moores Cancer Center, University of California, San Diego, La Jolla, California. Phillip Gardiner, PhD, is a Social and Behavioral Sciences and Nicotine Dependence Research Administrator, Tobacco Related Disease Research Program (TRDRP), Office of the President, University of California,
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15
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Building consumer demand for tobacco-cessation products and services: The national tobacco cessation collaborative's consumer demand roundtable. Am J Prev Med 2010; 38:S307-11. [PMID: 20176301 DOI: 10.1016/j.amepre.2009.12.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Revised: 05/29/2009] [Accepted: 12/02/2009] [Indexed: 11/24/2022]
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Murray RL, Bauld L, Hackshaw LE, McNeill A. Improving access to smoking cessation services for disadvantaged groups: a systematic review. J Public Health (Oxf) 2009; 31:258-77. [PMID: 19208688 DOI: 10.1093/pubmed/fdp008] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Smoking is a main contributor to health inequalities. Identifying strategies to find and support smokers from disadvantaged groups is, therefore, of key importance. METHODS A systematic review was carried out of studies identifying and supporting smokers from disadvantaged groups for smoking cessation, and providing and improving their access to smoking-cessation services. A wide range of electronic databases were searched and unpublished reports were identified from the national research register and key experts. RESULTS Over 7500 studies were screened and 48 were included. Some papers were of poor quality, most were observational studies and many did not report findings for disadvantaged smokers. Nevertheless, several methods of recruiting smokers, including proactively targeting patients on General Physician's registers, routine screening or other hospital appointments, were identified. Barriers to service use for disadvantaged groups were identified and providing cessation services in different settings appeared to improve access. We found preliminary evidence of the effectiveness of some interventions in increasing quitting behaviour in disadvantaged groups. CONCLUSIONS There is limited evidence on effective strategies to increase access to cessation services for disadvantaged smokers. While many studies collected socioeconomic data, very few analysed its contribution to the results. However, some potentially promising interventions were identified which merit further research.
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Affiliation(s)
- Rachael L Murray
- Division of Epidemiology and Public Health, UK Centre for Tobacco Control Studies, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, UK.
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Abstract
BACKGROUND Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. OBJECTIVES To assess the effectiveness of mass media interventions in reducing smoking among adults. SEARCH STRATEGY The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in March 2007. SELECTION CRITERIA Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series.Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included. Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes.The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, odds of being a smoker. DATA COLLECTION AND ANALYSIS Two authors independently assessed all studies for inclusion criteria and for study quality. One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of included studies and are presented narratively and in table form. MAIN RESULTS Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among nine campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the seven studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. AUTHORS' CONCLUSIONS There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign, while another (California) showed positive results only during the period of adequate funding and implementation. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.
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Affiliation(s)
- M Bala
- Jagiellonian University Medical College, 2nd Department of Internal Medicine, 8 Skawinska St, Krakow, Poland, 31-066.
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18
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Orleans CT. Increasing the demand for and use of effective smoking-cessation treatments reaping the full health benefits of tobacco-control science and policy gains--in our lifetime. Am J Prev Med 2007; 33:S340-8. [PMID: 18021909 DOI: 10.1016/j.amepre.2007.09.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 08/02/2007] [Accepted: 09/12/2007] [Indexed: 11/29/2022]
Abstract
More adults in the United States have quit smoking than remain current smokers. But 45 million adults (20.9%) continue to smoke, with highest rates among low socioeconomic status (SES), blue-collar, and Native American populations. More than two thirds (70%) of adult smokers want to quit, and approximately 40% make a serious quit attempt each year, but only 20%-30% of quitters use an effective behavioral counseling or pharmacologic treatment. The lowest rates of treatment use are seen in the populations with the highest rates of tobacco use. Fully harvesting the last 4 decades of progress in tobacco-control science and policy to increase smokers' demand for and use of cessation treatments represents an extraordinary opportunity to extend lives and reduce healthcare costs and burden in the next 30-40 years. This paper uses the "push-pull capacity" model as a framework for illustrating strategies to achieve this goal. This model recommends: (1) improving and communicating effective treatments for wide population use; (2) building the capacity of healthcare and other systems to deliver effective treatments; and (3) boosting consumer, health plan, and insurer demand for them through policy interventions shown to motivate and support quitting (e.g., clean indoor-air laws, tobacco tax increases, expanded insurance coverage/reimbursement) and efforts to improve treatment access and appeal, especially for smokers who use them least. Innovations recommended by the National Consumer Demand Roundtable for achieving "breakthrough" improvements in cessation treatment demand and use are described.
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Affiliation(s)
- C Tracy Orleans
- Robert Wood Johnson Foundation, Princeton, New Jersey 08543, USA.
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Nollen N, Ahluwalia JS, Mayo MS, Richter K, Choi WS, Okuyemi KS, Resnicow K. A randomized trial of targeted educational materials for smoking cessation in African Americans using transdermal nicotine. HEALTH EDUCATION & BEHAVIOR 2007; 34:911-27. [PMID: 17576774 DOI: 10.1177/1090198106294652] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines the efficacy of targeted versus standard care smoking cessation materials among urban African American smokers. Five hundred smokers (250 to each group) are randomized to receive a culturally targeted or standard care videotape and print guide. Both groups receive 8 weeks of nicotine patches and reminder telephone calls at Weeks 1 and 3. Process outcomes include material use and salience at 1 and 4 weeks postbaseline. Smoking outcomes include 7-day abstinence, smoking reduction, and readiness to quit at 4 weeks and 6 months postbaseline. Despite greater use of the targeted guide (68.8% vs. 59.6%, p < .05), intervention participants do not perceive the targeted materials as more salient, and no significant differences are found between groups on the smoking outcomes. Findings point to the importance of greater audience segmentation and individual tailoring to better match intervention materials to the needs of the priority population.
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Affiliation(s)
- Nicole Nollen
- University of Kansas Medical Center, Department of Preventive Medicine and Public Health, Kansas City 66160, USA.
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20
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Green LW, Orleans CT, Ottoson JM, Cameron R, Pierce JP, Bettinghaus EP. Inferring strategies for disseminating physical activity policies, programs, and practices from the successes of tobacco control. Am J Prev Med 2006; 31:S66-81. [PMID: 16979471 DOI: 10.1016/j.amepre.2006.06.023] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Revised: 06/07/2006] [Accepted: 06/23/2006] [Indexed: 11/17/2022]
Abstract
Efforts at reducing tobacco use in the United States and Canada over the last half century have been amazingly successful. This article examines those efforts in order to identify policies, programs, and practices found useful in tobacco control that might be usefully disseminated to world populations to improve rates of physical activity. Tobacco-control activities began with efforts to influence the individual smoker through public education and counter-advertising. Increasing awareness of the addictive properties of tobacco, industry efforts to manipulate those properties, and to target youth with aggressive advertising, fueled public outrage that supported additional policy changes to include community interventions, legal actions, and restraints against the tobacco industry. The article first examines ways to view the process of transferring knowledge from one enterprise (reducing tobacco consumption) to another (increasing physical activity). Several theories of knowledge generalization and dissemination are explored: transfer, knowledge utilization, application, diffusion, and implementation. The second section identifies the dissemination of tobacco control by means of brief health behavior-change interventions for smoking cessation that have been successfully integrated into primary clinical care. The question of whether similar strategies can be successfully disseminated to increase physical activity is examined in detail. The article then moves on to look at the success of arguably the most successful program in the world at achieving a reduction in tobacco control-the State of California. Finally, we compare and contrast some of the lessons as they have played out in another national context-Canada. In the concluding section, some lessons are identified that we believe may be successfully utilized in societal attempts to increase physical activity in world populations.
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Affiliation(s)
- Lawrence W Green
- University of California at San Francisco, San Francisco, California, USA.
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Squiers L, Bright MA, Rutten LJF, Atienza AA, Treiman K, Moser RP, Hesse B. Awareness of the National Cancer Institute's Cancer Information Service: results from the Health Information National Trends Survey (HINTS). JOURNAL OF HEALTH COMMUNICATION 2006; 11 Suppl 1:117-33. [PMID: 16641078 DOI: 10.1080/10810730600637517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Established in 1975, the National Cancer Institute's (NCI's) Cancer Information Service (CIS) is a national information and education network that serves the nation by providing the latest scientific cancer information to the American public. The purpose of this study was to determine the public's awareness of the CIS and other national cancer and health organizations by analyzing data from the NCI's Health Information National Trends Survey (HINTS 2003). This study also examined sociodemographic, health, and communication correlates of awareness of CIS and other national health organizations: American Cancer Society (ACS), National Institutes of Health (NIH), and NCI. Results indicated that awareness of the CIS was low (32.8%). Some subgroups were more likely to be aware of the CIS than others. When comparing awareness levels of the four national health organizations, marked differences in patterns of awareness among specific subgroups emerged for many sociodemographic variables. For example, minority groups were significantly more aware of the CIS than Whites; however, for all three other organizations a greater percentage of Whites were aware of each organization. For the NIH, NCI, and ACS, respondents in the highest income group were most aware of each organization and, as income level increased awareness also increased. The CIS, respondents with the lowest income levels, however, were more aware of the CIS compared with middle- and high-income groups. A similar pattern was found for other sociodemographic variables. Results of this study will guide the development of a targeted promotional campaign for the CIS.
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Affiliation(s)
- Linda Squiers
- Office of Cancer Information Service, National Cancer Institute, Bethesda, Maryland 20850, USA.
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Bright MA. The National Cancer Institute's cancer information service: a new generation of service and research to the nation. JOURNAL OF HEALTH COMMUNICATION 2005; 10 Suppl 1:7-13. [PMID: 16377597 DOI: 10.1080/10810730500263687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The National Cancer Institute (NCI), the nation's leading agency for cancer information and research, mandated by the U.S. Congress to provide accurate, up-to-date information about cancer to all segments of the U.S. population, established the Cancer Information Service (CIS) on July 1, 1975. Using a two-pronged approach, the telephone information service and education programs for the public and health professionals, the CIS was designed to maximize its reach. In 1982, the CIS implemented three tools: the Call Record Form to record data about each call to the service, a national user survey, and a system of national test calls. These resulted in a rich data source and an infrastructure that allowed collaborative health communications research with the CIS to emerge later in the decade. As the CIS embarks on a new generation of service to the nation, it is now characterized by three vital components that advance the NCI's overall mission of cancer prevention and control: a Partnership Program, Multichannel Contact Centers, and a Health Communications Research Program.
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Affiliation(s)
- Mary Anne Bright
- Office of Cancer Information Service, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-8322, USA.
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Ellis P, Robinson P, Ciliska D, Armour T, Brouwers M, O'Brien MA, Sussman J, Raina P. A Systematic Review of Studies Evaluating Diffusion and Dissemination of Selected Cancer Control Interventions. Health Psychol 2005; 24:488-500. [PMID: 16162043 DOI: 10.1037/0278-6133.24.5.488] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
With this review, the authors sought to determine what strategies have been evaluated (including the outcomes assessed) to disseminate cancer control interventions that promote the uptake of behavior change. Five topic areas along the cancer care continuum (smoking cessation, healthy diet, mammography, cervical cancer screening, and control of cancer pain) were selected to be representative. A systematic review was conducted of primary studies evaluating dissemination of a cancer control intervention. Thirty-one studies were identified that evaluated dissemination strategies in the 5 topic areas. No strong evidence currently exists to recommend any one dissemination strategy as effective in promoting the uptake of cancer control interventions. The authors conclude that there is a strong need for more research into dissemination of cancer control interventions. Future research should consider methodological issues such as the most appropriate study design and outcomes to be evaluated.
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Affiliation(s)
- Peter Ellis
- Hamilton Regional Cancer Centre, Hamilton, ON, Canada
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Martin M, Leonard M, Allen S, Botchwey N, Carney M. Commentary: Using culturally competent strategies to improve traffic safety in the black community. Ann Emerg Med 2004. [DOI: 10.1016/j.annemergmed.2004.07.435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fagan P, King G, Lawrence D, Petrucci SA, Robinson RG, Banks D, Marable S, Grana R. Eliminating tobacco-related health disparities: directions for future research. Am J Public Health 2004; 94:211-7. [PMID: 14759929 PMCID: PMC1448230 DOI: 10.2105/ajph.94.2.211] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Certain groups in the United States remain at high risk and suffer disproportionately from tobacco-related illness and death despite progress made in reducing tobacco use. To address gaps in research on tobacco-related disparities and develop a comprehensive agenda aimed at reducing such disparities, representatives from funding agencies, community-based organizations, and academic institutions convened at the National Conference on Tobacco and Health Disparities in 2002. Conference participants reviewed the current research, identified existing gaps, and prioritized scientific recommendations. Panel discussions were organized to address research areas affecting underserved and understudied populations. We report major research recommendations made by the conference participants in several scientific domains. These recommendations will ultimately help guide the field in reducing and eliminating tobacco-related disparities in the United States.
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Affiliation(s)
- Pebbles Fagan
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7337, USA.
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Fiore MC, Croyle RT, Curry SJ, Cutler CM, Davis RM, Gordon C, Healton C, Koh HK, Orleans CT, Richling D, Satcher D, Seffrin J, Williams C, Williams LN, Keller PA, Baker TB. Preventing 3 million premature deaths and helping 5 million smokers quit: a national action plan for tobacco cessation. Am J Public Health 2004; 94:205-10. [PMID: 14759928 PMCID: PMC1448229 DOI: 10.2105/ajph.94.2.205] [Citation(s) in RCA: 162] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2003] [Indexed: 11/04/2022]
Abstract
In August 2002, the Subcommittee on Cessation of the Interagency Committee on Smoking and Health (ICSH) was charged with developing recommendations to substantially increase rates of tobacco cessation in the United States. The subcommittee's report, A National Action Plan for Tobacco Cessation, outlines 10 recommendations for reducing premature morbidity and mortality by helping millions of Americans stop using tobacco. The plan includes both evidence-based, population-wide strategies designed to promote cessation (e.g., a national quitline network) and a Smokers' Health Fund to finance the programs (through a 2 US dollar per pack excise tax increase). The subcommittee report was presented to the ICSH (February 11, 2003), which unanimously endorsed sending it to Secretary Thompson for his consideration. In this article, we summarize the national action plan.
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Affiliation(s)
- Michael C Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin Medical School, Madison, 53711, USA.
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King G, Mallett RK, Kozlowski LT, Bendel RB. African Americans' attitudes toward cigarette excise taxes. Am J Public Health 2003; 93:828-34. [PMID: 12721152 PMCID: PMC1447847 DOI: 10.2105/ajph.93.5.828] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2002] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study examined African Americans' opinions regarding cigarette excise taxes and other tobacco control issues. METHODS A stratified cluster sample of US congressional districts represented by African Americans was selected. African Americans from 10 districts were interviewed. RESULTS Forty-seven percent of respondents stated that taxes on tobacco products should be increased, whereas about 30% believed that they should be reduced. Almost 75% disagreed that raising taxes on tobacco products is unfair to African Americans, and 57.9% reported that they would not be opposed to increasing taxes on cigarettes even if low-income smokers would be hit the hardest. CONCLUSIONS The present results indicate substantial support for cigarette excise taxes among African Americans.
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Affiliation(s)
- Gary King
- 315 Health and Human Development East, Pennsylvania State University, University Park, PA 16802, USA.
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Cabrera-Pivaral CE, Ninel Mayari CL, Arredondo Trueba JM, Gonzalez Perez GJ, Vega Lopez MG, Valadez Figueroa I, Aldrete Rodriguez MG. Evaluación de dos estrategias de educación nutricional vía radio en Guadalajara, México. CAD SAUDE PUBLICA 2002; 18:1289-94. [PMID: 12244361 DOI: 10.1590/s0102-311x2002000500021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
La modificación de los conocimientos y de las actitudes desde la óptica de la comunicación persuasiva en salud vía radio ha reportado resultados alentadores para los planificadores sanitarios. El objetivo fue medir el efecto de una estrategia educativa en los conocimientos y en las actitudes, utilizando el radio, en dos comunidades marginadas. Es una intervención educativa vía radio en dos comunidades marginadas y socioeconómicamente homogéneas en Guadalajara, Jalisco, México. Se seleccionaron al azar dos comunidades marginadas y se formaron dos grupos de radioescuchas, se midieron los conocimientos y las actitudes sobre contenidos de educación nutricional para la salud mediante un instrumento codificado y estructurado. El primer grupo "A", de 37 sujetos, fue organizado y expuesto a la dinámica del radio foro durante los 4 meses que dura el proyecto. El grupo "B" (n = 33), no organizado, se expuso al proyecto radiofónico según su propia dinámica cultural. La mediana del grupo A para Conocimientos y Actitudes (CA), en la pre medición, fue de 56,8 y, para la pos medición, fue de 74,1 (W: p = -0,05). Para el grupo B, los CA fueron de 53 y 59,2, respectivamente (W: p = -0,05). Así se refuerzan las ventajas del radio foro como estrategia comunicativa en salud en el área de la nutrición humana.
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Affiliation(s)
- Carlos Enrique Cabrera-Pivaral
- Centro de Estudios en Salud, Población y Desarrollo, Centro Universitario en Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
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Marcus AC, Garrett KM, Kulchak-Rahm A, Barnes D, Dortch W, Juno S. Telephone counseling in psychosocial oncology: a report from the Cancer Information and Counseling Line. PATIENT EDUCATION AND COUNSELING 2002; 46:267-275. [PMID: 11932126 DOI: 10.1016/s0738-3991(01)00163-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Providing psychosocial counseling services to cancer patients and their significant others by telephone is emerging as an alternative to traditional (in-person) counseling programs in psychooncology. In this paper, data are reported describing the clients of such a program that has been in continuous operation since 1981: the Cancer Information and Counseling Line (CICL) of the AMC Cancer Research Center. An examination of call record forms completed between 1 June 1998 and 30 May 1999 (N = 1627) revealed that the vast majority of callers were female (77%), non-Hispanic White (77%), with at least some college education (62%). Only 27% were cancer patients/survivors, compared to 43% who were spouses, other relatives and friends of cancer patients/survivors, and 16% who were symptomatic callers. Breast cancer was by far the most frequently mentioned cancer site (30%). Although initial topics of inquiry were dominated by requests for medical information (77%), with only a small percentage of callers initially requesting psychosocial support and counseling (12%), by the time, the call was completed, 67% had received some form of psychosocial support and/or counseling. Recommendations for future research are discussed within the context of this review.
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Affiliation(s)
- Alfred C Marcus
- AMC Cancer Research Center, 1600 Pierce Street, Denver, CO 80214, USA.
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Hopkins DP, Briss PA, Ricard CJ, Husten CG, Carande-Kulis VG, Fielding JE, Alao MO, McKenna JW, Sharp DJ, Harris JR, Woollery TA, Harris KW. Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med 2001; 20:16-66. [PMID: 11173215 DOI: 10.1016/s0749-3797(00)00297-x] [Citation(s) in RCA: 324] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This report presents the results of systematic reviews of effectiveness, applicability, other effects, economic evaluations, and barriers to use of selected population-based interventions intended to reduce tobacco use and exposure to environmental tobacco smoke. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis of recommendations by the Task Force on Community Preventive Services (TFCPS) regarding the use of these selected interventions. The TFCPS recommendations are presented on page 67 of this supplement.
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Affiliation(s)
- D P Hopkins
- Division of Prevention Research and Analytic Methods, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Marcus AC, Heimendinger J, Wolfe P, Rimer BK, Morra M, Cox D, Lang PJ, Stengle W, Van Herle MP, Wagner D, Fairclough D, Hamilton L. Increasing fruit and vegetable consumption among callers to the CIS: results from a randomized trial. Prev Med 1998; 27:S16-28. [PMID: 9808821 DOI: 10.1006/pmed.1998.0405] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Results are reported from a large randomized trial designed to increase fruit and vegetable consumption among callers to the Cancer Information Service (CIS). METHODS CIS callers assigned to the intervention group received a brief proactive educational intervention over the telephone at the end of usual service, with two follow-up mailouts. Key educational messages and print material derived from the NCI 5 A Day for Better Health program were provided to intervention subjects. Subjects were interviewed by telephone at both 4-week (n = 1,672) and 4-month (n = 1,286) follow-up. RESULTS A single-item measure of fruit and vegetable consumption revealed a significant intervention effect of approximately 0.65 servings per day at 4-week follow-up (P < 0.001) and 0.41 servings per day at 4-month follow-up (P < 0.001). Using a seven-item food frequency measure that was also included in the 4-month interviews, a similar intervention effect of 0.34 servings per day was obtained (P = 0.006). The vast majority of CIS callers (88%) endorsed the strategy of providing 5 A Day information proactively. CONCLUSIONS A brief educational intervention delivered to CIS callers at the end of usual service was associated with an increase in self-reported fruit and vegetable intake.
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Affiliation(s)
- A C Marcus
- AMC Cancer Research Center, Denver, Colorado, 80214, USA
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Affiliation(s)
- A C Marcus
- AMC Cancer Research Center, 1600 Pierce Street, Denver, Colorado, 80214, USA
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Fleisher L, Woodworth M, Morra M, Baum S, Darrow S, Davis S, Slevin-Perocchia R, Stengle W, Ward JA. Balancing research and service: the experience of the cancer information service. Prev Med 1998; 27:S84-92. [PMID: 9808827 DOI: 10.1006/pmed.1998.0314] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The National Cancer Institute's Cancer Information Service (CIS), the nation's foremost resource for cancer information, has supported cancer control research throughout its 22-year history. The Cancer Information Service Research Consortium (CISRC) is a consortium established to fully involve the CIS in theory-based cancer control research. METHODS This paper focuses on the experiences of the CIS Project Directors in the development and implementation of three research projects within the CIS program. Conclusions are drawn from discussions that have taken place over time in such venues as conference calls, CISRC Members Council meetings, and project advisory meetings. RESULTS Overall, the CISRC/CIS collaboration has been successful. A number of factors have contributed to this success, including the perceived value of the research within the CIS and the mechanisms and structures established to foster collaboration. The lessons learned, based on the challenges and opportunities of implementing these intervention research projects within the operations of the regional CIS offices, are discussed. CONCLUSIONS Integration of research within a service program requires careful planning and preparation. Mutual benefit, shared ownership, consistency with current practice, staff training, and the value of research to each partner were essential ingredients to the success of this collaboration.
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Affiliation(s)
- L Fleisher
- Cancer Information Service, Fox Chase Cancer Center, 510 Township Line Road, Cheltenham, Pennsylvania, 19012, USA
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Marcus AC. The cancer information service research consortium: a brief retrospective and a preview of the future. Prev Med 1998; 27:S93-100. [PMID: 9808828 DOI: 10.1006/pmed.1998.0419] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The Cancer Information Service Research Consortium (CISRC) was initially funded by the National Cancer Institute (NCI) in 1993 to examine seven key research questions. In this paper, the final results pertaining to these seven research questions are briefly reviewed, as well as several key lessons that have been learned from this unique research collaboration. Also described is the second generation of CISRC research that was recently funded by the NCI and is now in its first year of development. The results obtained from the first generation of research should provide the Cancer Information Service, as well as other organizations and agencies, with several viable programmatic options for the future.
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Affiliation(s)
- A C Marcus
- AMC Cancer Research Center, 1600 Pierce Street, Denver, Colorado, 80214, USA
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Orleans CT, Boyd NR, Bingler R, Sutton C, Fairclough D, Heller D, McClatchey M, Ward JA, Graves C, Fleisher L, Baum S. A self-help intervention for African American smokers: tailoring cancer information service counseling for a special population. Prev Med 1998; 27:S61-70. [PMID: 9808825 DOI: 10.1006/pmed.1998.0400] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND African Americans remain a critically underserved group for smoking cessation interventions. This study tested the effectiveness of a tailored, culturally sensitive intervention for African American smokers who called the NCI Cancer Information Service (CIS) for help to quit smoking. METHODS This paper presents results of a 2-year study of tailored counseling strategies among African American smokers (n = 1,422) who called four regional CIS offices in response to a radio-based media campaign in 14 communities. Callers were randomly assigned to receive either the standard CIS quit smoking counseling and guide (Clearing the Air) or counseling and a guide (Pathways to Freedom) tailored to the quitting needs and barriers of African American smokers. Callers were predominantly female (63.6%). ages 20-49 (88%), with a high school education or more (84%). Median smoking history was 17 years; median smoking rate was 20 cigarettes/day. Standard (n = 689) and Tailored (n = 733) group subjects did not differ on most baseline measures. RESULTS On most measures, Standard and Tailored counseling/guides received similar ratings, but the Tailored guide was rated as having more appealing photos (P = 0.001) and as being more appropriate for family members (P = 0.003). Six-month follow-up with 893 subjects (response rates were 63% Standard, 62% Tailored, ns) showed significantly more quit attempts (P = 0.002) and greater use of prequitting strategies (P < 0.05) among Tailored than among Standard subjects, but no differences in self-reported 1-week abstinence (14.4% Standard, 16.2% Tailored) (ns). An opportunistic 12-month follow-up of subjects recruited in the last year of the study (n = 445) (response rates were 57% Standard, 60% Tailored, ns) showed a significantly higher quit rate (15.4% Standard, 25.0% Tailored) for Tailored subjects (P = 0.034). CONCLUSIONS Results show promise for tailored approaches to boost quit attempts and success rates among African American smokers.
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Affiliation(s)
- C T Orleans
- Robert Wood Johnson Foundation, Princeton, New Jersey, 08543, USA.
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Crane LA, Leakey TA, Woodworth MA, Rimer BK, Warnecke RB, Heller D, Sloan George V. Cancer information service-initiated outcalls to promote screening mammography among low-income and minority women: design and feasibility testing. Prev Med 1998; 27:S29-38. [PMID: 9808822 DOI: 10.1006/pmed.1998.0247] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The telephone information service of the Cancer Information Service (CIS) historically is most effective in eliciting calls from higher income, white women. This article describes the design and feasibility of a project that tested the use of telephone outcalls to extend the reach of the telephone information service to underserved women. METHODS Neighborhoods throughout Colorado were identified using a geodemographic database (INFORUM) that allowed selection of census block groups according to demographic characteristics. Households were assigned randomly to: (1) a control group; (2) an outcall-only group, which received "cold" telephone outcalls promoting screening mammography; and (3) an advance card plus outcall group, which received a card introducing the program prior to the outcall. RESULTS The use of INFORUM to target low-income, less educated, and black women was largely successful. While quality of intervention delivery was high, the protocol was labor intensive, requiring an average of 40 min to identify and counsel each eligible woman. The advance card did not increase acceptance of the outcalls. CONCLUSIONS This approach successfully extended the CIS's audience; however, its labor intensity may limit its applicability. Strategies for increasing the efficiency of outcall efforts are suggested.
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Affiliation(s)
- L A Crane
- Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado, 80262, USA
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